COVID-19 Hospitalisations in Delhi on the Rise: Notes From the COVID Wards
FIT speaks to Doctors in Delhi Hospital COVID wards about severe cases, ICU admissions and Oxygen requirement.
As countries report record high COVID-19 cases once again, closer to home, in the national capital, for instance, there have been reports of hospitalisations going up with doctors bracing themselves for a full-fledged 'third wave'.
The World Health Organisation has gone on record to warn against underestimating the Omicron variant by labelling it as 'mild'.
According to the WHO, although Omicron seems to be causing less severe symptoms as compared to Delta, especially in vaccinated individuals, it wouldn't be appropriate to call it mild, as it may lead to people not taking it seriously enough.
"Hospitals are becoming overcrowded and understaffed, which further results in preventable deaths from not only COVID-19 but other diseases and injuries where patients cannot receive timely care."Dr Tedros Adhanom Ghebreyesus, WHO Director-General
Is Omicron largely causing mild illness? Are hospitalisations and the demand for oxygen cylinders once again going up in Delhi? Are we downplaying Omicron by calling it 'mild'?
FIT speaks to doctors and critical care specialists from hospitals in Delhi to find out.
COVID-19 Hospitalisations Are on the Rise
All the doctors FIT spoke to confirmed that COVID-19 cases have been off the charts, and with it, hospitalisations have been going up too.
"On second January there was one patient, on third (there were) five, and on fifth there were seventeen (COVID) patients (admitted). After that I stopped counting," says Dr Ankush Gard, PG resident department of Anaesthesia and Intensive Care, Safdarjung Hospital, Delhi.
"These are only going to increase," he adds.
In fact, data from the Delhi government's daily COVID-19 bulletin shows a steady yet steep rise in COVID hospitalisations in the last 10 days.
Data: Delhi State Health Bulletin
... So are ICU Admissions, & Oxygen Requirement
"ICU admissions have started to go up, yes," says Dr Garg. "We're receiving two to three patients per day. Before 3 January, we had no (COVID) patients admitted to the ICU."
“Right now only those who require oxygen are being admitted to the ICU. Others are being kept in the wards. Whoever is in the ICU right is now either on high flow oxygen or on ventilator, ” Dr Vinay Kumar, Senior Resident, Critical Care and Anastasia at All India Institute of Medical Science, Delhi tells FIT.
"In the ward, on the first floor, currently 25 patients require oxygen support," he adds.
Dr Kumar explains that the COVID ward in the first floor has now been dedicated to patients who require oxygen support, and that those who are stable are being shifted to a different floor.
"Two patients in the ward are also on ventilators because of our ICU being full."Dr Vinay Kumar, Senior Resident, Critical Care and Anastasia at AIIMS, Delhi
Data: Delhi State Health Bulletin
The Silver Lining: Few Adverse Cases
Although ICU admissions and patients requiring Oxygen support have also been inching up, so far the doctors from the various hospitals we spoke to reported that these are restricted to the elderly and people with pre-existing comorbidities.
“Right now, out of the 30 COVID patients we have in the hospital, only one is in the ICU on high flow, nasal cannula oxygen, and she is a 71 year old with multiple comorbidities— chronic kidney disease, uncontrolled diabetes, obese," says Dr Sumit Ray, Head of Department, Critical Care Medicine Holy Family Hospital, Delhi.
Dr Kumar also reports a similar situation at AIIMS. All the 8 patients in ICU in his wing are high-risk patients with comorbidities.
He also adds, “there have been no cases yet, at least during my duty, where a young otherwise healthy person who is COVID infected requires oxygen support or ventilator support in the ICU like we had seen in the second wave.”
According to the doctors, the most common symptoms in patients getting admitted are fever, cough, headache and runny nose, with breathlessness being largely uncommon.
One reason for this is the nature of the virus itself.
According to Dr Ray, the infection is "mostly confined to the upper respiratory tract and the numbers whose lung will be affected is much smaller."
"The Omicron variant is able to attach to the upper respiratory tract but doesn't come down into the lungs, and not just because of its nature but more because of vaccines and also how our immune system has adapted to it."Dr Sumit Ray, critical care medicine, Holy Family Hospital, Delhi
He goes on to talk about how patients are a lot more panicky this time around, which is also driving up admissions at their hospital.
"There have been a lot of over-cautious admissions that now we are trying to restrict," he says.
"Some COVID positive patients are getting themselves admitted because they don't think that they can isolate themselves well enough at home, or there are people at home who have significant comorbidities, or elderly parents."Dr Sumit Ray, critical care medicine, Holy Family Hospital, Delhi
Although cases are mostly mild, he adds, "those who are requiring oxygen have the same kind of CT findings that COVID patients had in the previous waves.”
'This is Not Even the Peak': No time for Complacency
"Some people have been saying that this variant is milder, but we haven’t experienced that yet. Oxygen requirement is going up in patients who have comorbidities."Dr Vinay Kumar, Senior Resident, Critical Care and Anastasia at AIIMS, Delhi
An influx of cases means a strain on the healthcare system. AIIMS Delhi has already officially put a halt on all non-essential surgeries to focus their available resources on COVID management.
Another resident doctor from AIIMS who wanted to remain anonymous explains, "After this COVID wave started (the end of December), we have converted our trauma centre almost completely into a COVID centre."
"We are gradually converting the trauma centre to a full COVID dedicated centre, along with that multiple other blocks like the burns and plastic surgery blocks, as well as a few ICU in the main department, are being converted into COVID wards," he adds.
"This is not even the peak of the wave. As we approach the peak, as the number of populations increase, and we do not convert if not the entire pool, but at least a significant amount of number for COVID patients, I don't think we will be able to manage in like next one or two weeks."Resident Doctor, AIIMS, Delhi
Speaking of the situation in Safdarjung Hospital, Dr Garg says, "we were working with four covid ICUs with twenty beds each in the previous two waves. Currently, only 1 ICU is dedicated to COVID patients, but when we start to see a surge in cases, we will have to convert other ICUs into COVID ones as well."
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